Pharmacology quiz #4 study

A female client with a six-month-old infant has been prescribed propylthiouracil (PTU). What is the most important question the nurse should ask this client?

"Are you breastfeeding your child?"

A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching?

"Do not take antihistamines with this medication."

A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describes the action of glipizide?

"Glipizide stimulates your pancreas to release insulin."

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

"Heparin does not dissolve clots. It stops new clots from forming.'

A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching?

"I have started taking ginger root to treat my joint stiffness."

A nurse is teaching a client who has multiple sclerosis and a new prescription for dantrolene. Which of the following statements by the client indicates an understanding of the teaching?

"I need to apply a sunscreen when I go outside."

Glucorticoids- A nurse is teaching a client who has diabetes mellitus and a new prescription for prednisone for a rash. Which of the following statements by the client indicates the need for further teaching?

"I will gradually stop the prednisone when my rash goes away." Answer Rationale: The client should discontinue glucocorticoids gradually to reduce the risk for adrenal insufficiency. Manifestations of adrenal insufficiency include nausea, vomiting, confusion, and hypotension.

A nurse is providing teaching to a client who is taking warfarin about monitoring its therapeutic effects. Which of the following explanations should the nurse provide about the international normalized ratio (INR) test?

"The INR is a standardized test that eliminates the variations between laboratories reports in prothrombin times."

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?

"Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."

A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?

"You might have to stop taking this medication 5 days before any planned surgeries."

A nurse is providing education to a client who will soon begin taking levothyroxine for the first time. Which teaching point should the nurse include in this education session?

"You'll most likely take this drug for the rest of your life."

When a patient is on Coumadin, the INR (International Normalized Ratio) levels will need to be monitored to ensure that they are in the therapeutic range. What is the therapeutic INR level?

2 to 3

A client asks the nurse what dose of acetylsalicylic acid (aspirin) is needed for antiplatelet effects to prevent heart attacks. What dose is most appropriate to reduce platelet aggregation?

300 mg 300-325 mg/d is the usual dosage to reduce risk of death or nonfatal MI in patients with a past history of MI or with angina

A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective?

A decrease in urine output

A patient is starting warfarin (Coumadin) therapy as part of treatment for atrial fibrillation. The nurse will follow which principles of warfarin therapy? (Select all that apply.)

Administer the oral dose at the same time every day Assess carefully for excessive bruising or unusual bleeding Monitor laboratory results for a target INR of 2 to 3

A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?

Adrenocortical insufficiency

A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication?

Alcohol Answer Rationale: The nurse should teach the client to avoid alcohol while taking this medication to prevent a disulfiram reaction, such as nausea, headache, and hypoglycemia.

The nurse is caring for a client who has been prescribed glyburide. Which factor, if identified in the client history, would cause the nurse to inform the health care provider of a contraindication to use?

Allergy to sulfonamides

Mr. Frank, on warfarin (Coumadin) will also not be able to take which of the following medications for gout because it interferes with hepatic drug-metabolizing enzymes that are responsible for inactivating warfarin?

Allopuirinol

What drug can be given to reverse the thrombolytic effects after thrombolytic therapy(altplase), to help a patient clot?

Aminocaproic acid (Amicar

Both clopidogrel (Plavix) and ticlopidine (Ticlid) are:

Antiplatelet/ADP inhibitors

Mr. Frank, on warfarin (Coumadin) will not be able to take which of the following medications for gout pain, because it is an antiplatelet drug and may also lessen the effectiveness of probenecid?

Aspirin

A nurse is caring for a client receiving metformin drug therapy to improve glycemic control. What adverse reaction to the drug should the nurse monitor the client for?

Asthenia

Prior to thrombolytic therapy, one should ensure that the client has not been on which of the following drugs, which could enhance bleeding?

B. Ibuprofen

A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?

Baclofen

Which skeletal muscle relaxant is also available in intrathecal form?

Baclofen

Which other drug could Mr. Frank not be able to take because it would inhibit medication metabolizing enzymes that increase levels of warfarin?

Cimetidine (Tagamet)

A nurse is preparing to administer an antiplatelet drug. Which medication would the nurse likely administer?

Clopidogrel

A client with a history of malignant hyperthermia is scheduled for surgery. Which agent would the nurse most likely expect to administer?

Dantrolene

A client with amyotrophic lateral sclerosis is experiencing muscle spasticity. Which drug would the nurse expect the physician to order?

Dantrolene

A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication?

Decrease in level of thyroid stimulating hormone (TSH)

A HCP is caring for a patient who is about to begin taking dantrolene for skeletal muscle spasms. The HCP should tell the patient to report which of the following adverse effects?

Diarrhea. Other adverse effects include nausea and vomiting.

A nurse is caring for a client who is exhibiting signs of alcohol withdrawal. Which of the following medications should the nurse plan to administer?

Diazepam

A nurse is teaching a client who has a new prescription for diazepam. Which of the following information should the nurse include in the teaching?

Diazepam can cause drowsiness.

The client is taking baclofen. What would be the most important safety instruction for the nurse to give to this client?

Discontinue the use of alcohol

The drugs streptokinase (Streptase), Alteplase (tPA), and Reteplase (Retavase) are thrombolytic medications that have which one of the following actions?

Dissolve clots already formed, by conversion of plasminogen to plasmin

Anticonvulsants

Divalproex (oral, another name for valproic acid), topiramate

The client is prescribed warfarin. His INR is 5.2. At what level is this dose?

Elevated

A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following prescriptions for this client?

Enoxaparin

Which of the following drugs is an anticoagulant that can be given parenterally and cannot be given orally?

Enoxaparin (Lovenox)

A client is admitted with thrombophlebitis and sent home on enoxaparin therapy. Which statement indicates a good understanding of why enoxaparin is being administered?

Enoxaparin inhibits the formation of additional clots.

A nurse is receiving a client who is immediately postoperative following hip arthroplasty. Which of the following medications should the nurse plan to administer for DVT prophylaxis?

Enoxaparin subcutaneous

Second-line = Migraine meds: -Ergot alkaloids

Ergotamine - (oral, sublingual, rectal, second choice: for hypertensive patients)

A nurse is obtaining a medical history from a client who is to start warfarin therapy and currently uses herbal supplements at home. The nurse should inform the client that which of the following herbal supplements can interact adversely with warfarin?

Feverfew

A nurse is caring for a client who has diabetes mellitus and is taking pioglizatone. The nurse should plan to monitor the client for which of the following adverse effects?

Fluid retention

Which would a nurse expect to assess in a client experiencing hyperthyroidism?

Flushed, warm skin Clients with hyperthyroidism typically exhibit flushed, warm skin; hyperactive deep tendon reflexes; tachycardia; and intolerance to heat.

The nurse is providing education to a client who has been prescribed therapy with an antidiabetic medication. During teaching, the nurse will caution the client against heavy intake of which herb?

Garlic Garlic has been known to cause hypoglycemia when taken with antidiabetic medications.

. A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which would the nurse expect to be ordered?

Glucagon

Which would a nurse identify as an example of a sulfonylurea?

Glyburide

The nurse is preparing to administer a scheduled dose of levothyroxine to a client. What assessment should the nurse perform prior to giving the drug?

Heart rate

The nurse is providing education to a client who has been prescribed dantrolene. What serious adverse effect should the nurse mention during teaching?

Hepatitis

A nurse is planning to administer IV alteplase (Activase) to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the following interventions is appropriate for the nurse to plan?

Hold direct pressure on puncture sites for up to 30 minutes

A client has been prescribed a corticosteroid for the treatment of chronic adrenocortical insufficiency. The nurse's instructions for administration should include taking the medication under what condition?

In the morning

A nurse is assessing a client who is receiving liothyronine for treatment of hypothyroidism. The nurse should recognize which of the following findings is a therapeutic response to this medication?

Increase in energy

All corticosteroids are derived from cholesterol and are released directly into the bloodstream. What is a hematological adverse effect from the use of corticosteroids?

Increased serum cholesterol

Mannitol (Osmotic Diuretic) when you hear something about osmolarity think about mannitol

Indications: 3! -To reduce intraocular or intracranial pressure or cerebral edema. - To produce diuresis in drug intoxication. - To prevent or treat oliguria or acute renal failure.

A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions?

Infection

A nurse taking a medical history on a client prescribed a corticosteroid medication should focus on which condition?

Infections

A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse take?

Insert the syringe needle halfway into the client's skin

A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose?

Insomnia Answer Rationale: Levothyroxine overdose will result in manifestations of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia

A nurse is providing teaching to a client who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client?

Levothyroxine

A HCP is caring for a patient who is about to begin taking dantrolene (Dantrium) forskeletal muscle spasms. The HCP should recognize that which of the following laboratory tests requires monitoring?

Liver function liver toxicity is a serious side effect of dantrolene.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?

Migraine headaches

A nurse is teaching a client who has a new prescription for aspirin to prevent cardiovascular disease. Which of the following instructions should the nurse include in the teaching?

Monitor for tinnitus. Answer Rationale: Tinnitus is a manifestation of salicylism, or aspirin toxicity. Other manifestations include sweating, headache, and dizziness.

A nurse is providing teaching to a female client who has type 2 diabetes and a new prescription for pioglitazone. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Monitor weight daily. Increase calcium intake.

Based on the nurse's knowledge about thyroid hormone supplements, the nurse administers levothyroxine cautiously to a client who has recently had which condition or disorder?

Myocardial infarction

asprin if taken with what medication can increase bleeding risk ?

NSAIDS

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

Observe the patient for hypoglycemic episodes

A nurse is caring for a client who has atrial fibrillation and has a new prescription for dabigatran (Pradaxa) to prevent development of thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran?

Omeprazole (Prilosec)

What drug type is most likely to cause respiratory depression and myxedema coma in clients with thyroid disorders?

Opioid analgesics

A nurse is reviewing laboratory results of a client who has atrial fibrillation and is taking warfarin. For which of the following results should the nurse notify the provider?

PT 45 seconds

A client is receiving heparin. Which would the nurse use to monitor the effects of the drug?

Partial thromboplastin time (PTT)

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?

Prednisone Answer Rationale: Corticosteroids such as prednisone can cause glucose intolerance and hyperglycemia. The client might require increased dosage of a hypoglycemic medication.

A nurse is caring for a client who is receiving heparin by continuous IV infusion. Which of the following medications should the nurse plan to administer in the event of an overdose?

Protamine

A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?

Protamine sulfate

A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin?

Prothrombin time (PT)

The nurse is providing client education prior to administering propylthiouracil. During teaching, the nurse should inform the client about the need for what form of follow-up?

Routine liver function testing

Drug of choice for migraine crisis, not for patients with hypertension?

Sumatriptan

First-line - Migraine medications: Aspirin‑like medications: Acetaminophen, NSAIDs (aspirin, naproxen) Serotonin receptor agonists (triptans)

Sumatriptan (Drug of choice for migraine crisis, not for patients with hypertension)

The nurse should monitor a client for which effect of a drug interaction in a client taking thyroid hormones and a beta blocker?

Tachycardia

. A nurse is caring for a patient undergoing thyroid hormone replacement therapy. What should the nurse inform this patient regarding administration of the drug?

Take the drug before breakfast.

The nurse is providing client education regarding the administration of levothyroxine (Synthroid). Which information should the nurse include?

Take with a full glass of water

Which condition must be met in order for glyburide treatment to be effective?

The client must have functioning pancreatic beta cells

A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin?

The client uses garlic to lower cholesterol levels.

A nurse is caring for a client who has a fractured ulna and a new prescription for cyclobenzaprine. Before administering, which of the following explanations should the nurse provide to explain the purpose of the medication?

The medication will relieve muscle spasms that might occur with a fracture.

The nurse administers hydrocortisone cypionate (Cortef). What intervention is appropriate for this medication?

The nurse will monitor the patient's blood glucose level.

Prophylactic for Migraines

Tricyclic antidepressants: Amitriptyline (oral) Estrogens: Estrogen (gel, patches) also for migraine prophylaxis

A nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer?

Vitamin K

A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2. Which of the following medications should the nurse prepare to administer?

Vitamin K

What medication creates a safety risk when combined with long-term fludrocortisone therapy?

Warfarin

A nurse is providing client education to a female client who is taking fludrocortisone. The nurse will instruct the client to monitor what at home?

Weight gain

A client who has Graves' disease is prescribed methimazole. Which of the following effects should the nurse expect to see after the client has taken the medication for 2 months?

Weight loss

A female client has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid

adrenal insufficiency.

A client in on a direct thrombin inhibitor (DTI) for the treatment of deep vein thrombosis (DVT). Being on this medication allows the client the benefit of not having to go to the clinic for ongoing therapeutic drug level monitoring. What drug would the client be taking?

c) Dabigatran (Pradaxa)

Liothyronine is a thyroid hormone used in replacement therapy for hypothyroidism. The drug must be used with extreme caution in patients with

cardiac problems

Glucocorticoids precaution or caution with patients with:

diabetes mellitus

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:

hyperglycemia

The nurse should teach clients who are taking thyroid hormones to take the medication:

on an empty stomach

Prophylactic betablocker ?

propranolol

Causes of migraines?

stress lack of sleep bright light skipped meals